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Posts for category: Dental Procedures

YourDecayedToothMightNeedaDifferentKindofRootCanalTreatment

Advanced decay doesn't necessarily mean it's curtains for an infected tooth. Millions of teeth in that condition have been saved by a tried and true procedure called root canal therapy.

Although they may vary according to the complexity of a case, all root canal procedures share some similarities. After numbing the tooth and gum areas with local anesthesia, the procedure begins with a small hole drilled into the tooth to access the infected pulp and root canals, tiny passageways inside the root.

The dentist then uses special instruments to clear out infected tissue from the pulp and canals, followed by thoroughly sanitizing the resulting empty spaces. This is followed with filling the pulp chamber and root canals with a rubber-like substance (gutta percha) to seal the interior of the tooth from further infection. Later, the dentist typically crowns the tooth for further protection and support.

Root canals have become the standard treatment for teeth with advanced decay. There are, however, some circumstances where performing a root canal isn't a good idea. For example, a previously root-canaled tooth with a crown and supporting post. A dentist would need to fully disassemble the restoration to gain access into the tooth, which could significantly weaken it.

But there may be another option if a standard root canal is out of the picture: a surgical procedure performed by an endodontist (a specialist in interior tooth treatment) called an apicoectomy. Instead of drilling through the tooth crown, the endodontist accesses the tooth root through the adjacent gum tissue.

Like a traditional root canal, the procedure begins by anesthetizing the tooth and surrounding gums. The endodontist then makes a small incision through the gums to expose the diseased tissues at the tooth's root. After removing the infected tissue and a few millimeters of the root tip, they place a small filling to seal the end of the root canal against infection and suture the gum incision.

This is a specialized procedure that requires the state-of-the-art equipment and advanced techniques of an endodontist. But it does provide another possible option for saving a diseased tooth that might otherwise be lost.

If you would like more information on treatments for tooth decay, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Apicoectomy: A surgical Option When Root Canal Treatment Fails.”

RemovingaToothCouldHelpCorrectThisParticularBiteProblem

Dentists extract millions of teeth each year, mostly because of disease. But sometimes a healthy tooth is removed to gain a more favorable, long-term dental health outcome.

An example of this is extracting teeth for the sake of orthodontic treatment. This is often beneficial when treating bite problems caused by crowding, a condition in which not enough space on the jaw exists to accommodate all of the teeth coming in. When this happens, the limited space can force teeth out of their proper alignment.

Crowding also complicates correcting the bite problem with braces: As with the eruption phase, there's no available room for orthodontic movement. One solution that may arise after a detailed examination is to open up space on the jaw by removing some of the teeth.

Planning this kind of tooth extrication requires careful forethought with the end in mind—ultimately, the dental providers involved want the resulting appearance after braces to look as natural as possible. For that reason, dentists usually choose teeth for extraction that are outside of the "smile zone" (the teeth visible while smiling) like premolars and molars.

Additionally, dentists are concerned about bone loss after extracting the teeth. Bone often diminishes around empty tooth sockets, especially if those sockets were damaged during extraction. This loss in bone can weaken the jaw structure and cause significant problems while moving teeth with braces.

To avoid this, dentists take great care during tooth removal not to damage the socket. Additionally, they may place a bone graft within the socket immediately after removing the tooth, especially if the space will remain vacant for a significant period of time. A bone graft serves as a scaffold upon which new bone cells can form and accumulate.

After the extractions, the orthodontist may then proceed with correcting the bite. Patients may also need some form of prosthetic teeth to fill in the spaces while wearing braces. Often prosthetic teeth can be incorporated with the braces for a more natural look. After braces, any remaining gaps may require further restoration, either with dentures, bridges or, later in adulthood, dental implants.

Complex bite problems like crowding pose unique challenges in correcting them. But using techniques like tooth extraction can help achieve a successful and satisfactory outcome.

If you would like more information on treatments for bite problems, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Removal for Orthodontic Reasons.”

ImplantsCanProvideEffectiveOptionsforTotalToothReplacement

Losing all your teeth can dramatically impact your life for the worst. Fortunately, we can give you your "teeth" back. The most common way, at least until a few decades ago, is with custom dentures, which reasonably restore life-like appearance and dental function. But it does have one major drawback—it can't stop bone loss.

Loss of bone in the jaws often occurs with missing teeth. Normally, the bone continuously generates newer cells to replace older ones that have died. Chewing stimulates this growth as the force generated travels up through the teeth to the bone. But when teeth go missing, new bone growth slows, eventually causing the bone's volume and density to decrease.

Dentures can't reactivate this lost stimulation, and so bone loss may continue. Dentures even accelerate this loss as the compressive forces applied to the bony ridge are detrimental. This often leads to a "loosening" of a denture's fit that can make them uncomfortable and less secure to wear.

Today, however, patients with total tooth loss have another option that could alleviate the problem of bone loss—dental implants. Since their inception forty years ago, implants have become the preferred method of both dentists and patients for tooth replacement.

Implants consist of a titanium metal post that's surgically imbedded into the jawbone. Bone cells are attracted to this particular metal, readily multiplying and adhering to the implant's titanium surface. Because of this, an implant can slow or even stop bone loss.

Most people are familiar with the single tooth implant with an attached lifelike crown. Although this use of implants could be used to restore total tooth loss, it can be quite costly replacing over two dozen teeth individually.

But implants could still be part of the answer for someone with complete tooth loss, because they can also be used to support traditional restorations. A few implants strategically placed around the jaw can support either a removable denture or a fixed bridge.

Besides being a cost-effective way to add support to these traditional tooth replacements, the inclusion of implants will likely decrease continuing bone loss. Most importantly, it can give you back your dental function—and your smile to boot.

If you would like more information on dental implant options, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “New Teeth in One Day.”

By Applewood Dental
September 03, 2021
Category: Dental Procedures
Tags: clear aligners  
ClearAlignersAnotherOptionBesidesBracesforMovingTeeth

Advances in technology often lead to greater choices for things like automobiles or smartphones. In recent decades, advances in orthodontics have given families another choice besides braces for straightening teeth: clear aligners.

Clear aligners are a series of computer-generated mouth trays of clear plastic that are custom made for an individual patient's teeth. Like braces, these trays worn in the mouth put pressure on the teeth to move in a desired direction. Patients wear an individual tray for about two weeks and then change it out for the next tray in the series. Each subsequent tray is designed to pick up where the former tray left off in the progress of tooth movement.

Although treatment takes about as along as braces, clear aligners have some distinct advantages. First and foremost, their clear plastic construction makes them nearly invisible to outside observers. This makes them ideal for appearance-conscious teens (or adults) who may be embarrassed by the look of metallic braces.

And unlike their fixed counterpart, clear aligners can be removed by the wearer for meals, hygiene and the rare special occasion. As a result, patients with aligners aren't as restricted with food items and have an easier time keeping their teeth clean and avoiding dental disease than braces wearers.

But although definitely a benefit, removability can be potentially problematic depending on the maturity level of the patient. To be effective, an aligner tray must remain in the mouth for the majority of the time—too much time out negates the effect. Patients, then, must be responsible with wearing aligners as directed.

Clear aligners may also not work for treating difficult bites, especially those that require targeted movement (or non-movement) of select teeth. In those cases, braces may be the necessary treatment. But this situation has changed in recent years with the development of new devices and techniques that increase the range of bite problems clear aligners can treat.

Depending then on the bite problem and a patient's level of personal responsibility, clear aligners can be a viable orthodontic choice. And just like braces, they too can improve both dental function and appearance.

If you would like more information on orthodontic options for teens, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Clear Aligners for Teens.”

DontBeWaryofaRootCanal-HeresHowItCouldSaveYourTooth

Here's the bad news: One of your teeth has tooth decay. But here's even worse news: The decay has entered the pulp and root canals in the heart of the tooth. You're well on your way to losing that tooth.

But cheer up—root canal therapy might save your decayed tooth. We use root canal therapy to remove the infection from within a tooth and then fill the resulting empty spaces to prevent further infection. This routine procedure has saved millions of teeth.

But alas, along the way root canals somehow became a cultural symbol for unpleasantness. In reality, there's nothing further from the truth—the procedure itself is painless, and may even stop any pain caused by tooth decay.

So, let's take the mystery out of root canal therapy—the more you know, the less wary you'll feel. Here's what to expect if you undergo this tooth-saving procedure.

Preparation. We start by numbing the tooth and surrounding gums with local anesthesia. While we're waiting for the anesthesia to take full effect, we isolate the tooth with a dental dam to prevent cross-contamination to other teeth.

Access. Next, we drill a small opening into the tooth to access the pulp and root canals. If it's one of the large back teeth, we drill the hole in the tooth's biting surface; in a narrower front tooth, we make the access opening in the rear surface.

Removal. We remove tissue from the pulp and root canals using special instruments. Afterward, we thoroughly disinfect the pulp and canal interiors with an antibacterial solution to ensure we've stopped the infection.

Filling. After re-shaping the root canals, we fill them and the pulp chamber with gutta percha, a rubber-like material ideal for this type of dental situation. We then fill and seal the access hole. In a few weeks, you'll return to have a permanent crown installed to further protect the tooth.

You may have some minor discomfort that's usually manageable with mild pain relievers, and should dissipate over a few days. The good news, though, is that we've more than likely saved a tooth that might have otherwise been lost.

If you would like more information on treating a decayed tooth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “A Step-By-Step Guide to Root Canal Treatment.”



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